The authors established that, in a modern paediatric burn care setting, a burn size of roughly 60% total body surface area (TBSA) is a crucial threshold for postburn morbidity and mortality. On the basis of these findings, the authors recommend that paediatric patients with greater than 60% TBSA burns be immediately transferred to a specialised burn centre. Furthermore, at the burn centre, patients should be treated with increased vigilance and improved therapies, in view of the increased risk of poor outcome associated with this burn size.